CAJ | 학술논문

目的：探讨局部麻醉下行开放式腹膜前疝修补术的可行性和实用性。方法回顾性分析河南省漯河疝外科医院2011年2月至2012年3月采用预裁剪补片经腹膜前间隙治疗腹股沟疝326例，其中直疝257例，斜疝63例，骑跨疝6例；原发疝314例，复发疝12例。术后对患者疼痛、皮下血肿、阴囊浆液肿、切口感染等并发症及复发情况进行7 d 至15个月的随访。结果本组314例原发疝患者平均手术时间（70±15）min，12例复发疝患者平均手术时间（120±50）min。3例斜疝患者因在建立腹膜前间隙时出血而中转 Litenstein 术式。术后平均住院时间（3．0±1．0）d，平均住院费用2078元。在随访期间术后疼痛者227例，口服盐酸曲马多止痛药50 mg，1～2次后疼痛均缓解，未出现术后慢性疼痛，无切口皮下血肿，无切口感染，阴囊浆液肿 3例，经门诊抽吸 1～2次均消失痊愈。1例复发疝于术后2个月时再次出现复发。结论在局部麻醉下行开放式腹膜前间隙修补术术后并发症少，是一种经济、安全、实用的手术方法。
목적：탐토국부마취하행개방식복막전산수보술적가행성화실용성。방법회고성분석하남성탑하산외과의원2011년2월지2012년3월채용예재전보편경복막전간극치료복고구산326례，기중직산257례，사산63례，기과산6례；원발산314례，복발산12례。술후대환자동통、피하혈종、음낭장액종、절구감염등병발증급복발정황진행7 d 지15개월적수방。결과본조314례원발산환자평균수술시간（70±15）min，12례복발산환자평균수술시간（120±50）min。3례사산환자인재건립복막전간극시출혈이중전 Litenstein 술식。술후평균주원시간（3．0±1．0）d，평균주원비용2078원。재수방기간술후동통자227례，구복염산곡마다지통약50 mg，1～2차후동통균완해，미출현술후만성동통，무절구피하혈종，무절구감염，음낭장액종 3례，경문진추흡 1～2차균소실전유。1례복발산우술후2개월시재차출현복발。결론재국부마취하행개방식복막전간극수보술술후병발증소，시일충경제、안전、실용적수술방법。
Objective To explore the feasibility and practicality of open preperitoneal hernia repair under local anesthesia.Methods A retrospective analysis was conducted on 326 patients with inguinal hernia who underwent preperitoneal hernia repair with pre-shaped mesh in Luohe Hernia Surgery Hospital from February 201 1 to March 201 2.Of these,there were 257 direct hernia,63 indirect hernia,and 6 saddle hernia;31 4 primary hernia,and 1 2 recurrent hernia.The complications such as pain,subcutaneous hematoma,scrotal seroma,wound infection and recurrence were recorded during follow-up period of 7 days to 1 5 months.Results It took mean of (70 ±1 5)minutes for the operations of primary hernia (31 4 cases) and (1 20 ±50)minutes for recurrent hernia.3 conversions to Lichtenstein repair in indirect hernia were necessary because of bleeding in preperitoneal space.The average length of postoperative stay was (3.0 ± 1 .0)days,and the mean cost was ￥2078.During the follow-up period,there were 227 cases of postoperative pain,who achieved relief after giving 1 to 2 times painkillers (50 mg tramadol hydrochloride). No chronic pain,subcutaneous hematoma and wound infection were found.3 cases of scrotal seroma occurred,which disappeared by puncture and aspiration in outpatient.A recurrent hernia relapsed at 2 months after the operation.Conclusion Open preperitoneal hernia repair under local anesthesia can reduce postoperative complications,and shows to be an economical,safe and practical procedure.